By Blair Hanewall, Bill and Melinda Gates Foundation
There is much to celebrate in global health in the last two decades: cutting child mortality in half, nearly halving maternal mortality, increasing global DTP3 coverage to more than 85% in 2015, and much more. While these successes can be attributed to many factors, a key driver has been leveraging market dynamics to drive uptake of health products and services.
There are many recent examples of overcoming market barriers to increase access to health products in low income markets. My colleague Susan Nazzaro, as part of the Markets Matter blog series, highlighted several: bed nets, HIV treatment, and long-acting contraceptives. There are likewise many examples among vaccines, including successful efforts to make rotavirus, pentavalent and meningitis vaccines more affordable. These examples underscore an area where PSI is a leader: understanding the needs of populations and the demand for these important health products. This allows for smarter negotiations on product pricing, supply and quality in order to get the right products to the right people at the right price.
As a global community we have been more effective at addressing market barriers for what we think of as more responsive markets – markets where products are bought by a small number of entities, policy and regulatory pathways are clear, established delivery channels exist, and minimal coordination or interaction is required with other interventions. Yet we believe that these kinds of markets are going to be less common in the future.
These changes are exciting. We anticipate stronger primary healthcare systems that strategically purchase products and services independently, context-specific policy decisions, increasing diversity of service delivery channels – including vending machines, mobile orders and self-managed care – and primary care systems aiming to meet holistic needs of patients from preventive to communicable and non-communicable diseases.
But we also see challenges with this more diverse and fragmented market. For example, if we can’t estimate strategic demand or coordinate purchasing among independent buyers, how do we create pull mechanisms to incentivize innovation for the next pandemic? How do we coordinate purchasing to secure affordable pricing for new, expensive health products? How do we coordinate the deployment of drugs or insecticidal chemicals to minimize development of resistance? In short, how do we find global, regional, and country strategies that will still allow us to influence health markets in this future?
Some organizations are already taking up the challenge. PSI’s ACT and FP Watch are platforms that provide market intelligence to understand demand; others are tapping mapping and mobile data. Buyers like GFATM and GAVI are exploring online buying and more sophisticated forecasting. More countries are using a common health technology assessment methodology to facilitate strategic purchasing.
We aren’t starting from scratch. The plea is that, as we design local solutions, let’s consider how these approaches can help solve tomorrow’s global market failures as well. We’ve got a good thing going. Let’s not lose it.
Blair Hanewall is the Deputy Director for Integrated Delivery at the Bill & Melinda Gates Foundation.
This article is part of an ongoing conversation about #MakingMarketsWork in Impact Magazine No. 22 “Are We Thinking Big Enough” issue. Join in the conversation with @PSIImpact.
Photo courtesy: Jake Lyell